Somatostatin in the management of gastrointestinal fistulas. A multicenter trial
A. J. Torres, J. I. Landa, M. Moreno-Azcoita, J. M. Arguello, G. Silecchia, J. Castro, F. Hernandez-Merlo, J. M. Jover, E. Moreno-Gonzales and J. L. Balibrea
Department of Surgery, University Hospital of San Carlos, Madrid, Spain.
To evaluate the effectiveness of treatment with total parenteral nutrition
(TPN) alone (group A) or combined with continuous intravenous infusion of
somatostatin (group B) in postoperative gastrointestinal fistulas, a
multicenter, controlled and prospective randomized trial was designed. We
present the results obtained after the evaluation of 40 cases (group A, n =
20; group B, n = 20). No significant differences among these treatment
schedules were observed in the percentage of closure of fistulas (group A,
81.25%; group B, 85%), but patients treated with total parenteral nutrition
plus somatostatin had the fistulas close within a significantly shorter
period of time. Moreover, this treatment was associated with a
significantly lower morbidity. These preliminary results indicate that
somatostatin is a useful therapeutic complement in the conservative
treatment of patients with gastrointestinal fistulas.
